妇科术后患者留置镇痛泵发生尿潴留的临床分析及预防
【关键词】 妇科。
摘要：目的： 探讨经腹式全子宫切除术后病人留置镇痛泵的尿潴留情况及护理预防措施。方法：将82例腹式全子宫切除术后留置镇痛泵的病人随机分为两组。实验组41例，分别于术后43h取镇痛泵和术后48h取导尿管。对照组41例，于术后48h同时取镇痛泵和导尿管。对比两组尿潴留及经护理后重新留置导尿管的情况。结果： 实验组取导尿管后5h内能自解小便比率明显高于对照组（p0.01），重新留置导尿管比率低于对照组(p0.05)。结论：腹式全子宫切除术后取镇痛泵5h后再取导尿管，可减少尿潴留的发生。
The clinical analysis and prevention of urine retention postoperative epidural analgesia after hysterectomy。
Abstract: Objective: To analyze the development and prevention of urine retention postoperative epidural analgesia after hysterectomy. Method: 82 patients who received epidural analgesia after hysterectomy were divided into two groups at random. In test group the patients were removed the epidural tubes postoperative 43 hours and removed the urine tubes postoperative 48 hours; in control group the patients were removed the epidural tubes and the urine tubes postoperative 48 hours at the same time. The followings were observed: urine retention, the preventive ways and the remaining of urine tubes after treatment. Results: The patients who could urinate in 5 hours after removing the urine tubes were more than those in the control group（p0.01）. The patients who have to remain urine tubes for the second time in the test group were less than those in the control group (p0.05). Conclusions: Removing the urine tube after 5 hours of removing the epidural tubes could prevent the patients who had postoperative epidural analgesia after hysterectomy from urine retention effectively.
Key words:epidural analgesic tube;hysterectomy;Urine retention。
随着病人对术后舒适度要求的增高, 镇痛泵逐渐被广大病人所采纳。镇痛泵与硬膜外导管或静脉通道相连，将药液按设定速度输入，具有良好的镇痛效果，用药量少且能维持准确稳定的血药浓度。但有研究认为镇痛过程中，由于药物的副作用、患者术后处于相对无痛期、静卧睡眠时间较长，膀胱功能的恢复均受到不同程度的影响，易发生尿潴留［1］。我们对此进行临床分析，并探讨相应的预防措施。
1资料与方法。
1.1一般资料：选择2005年6月至8月在我科行腹式全子宫切除术患者82例，年龄37～55岁，平均（48.3±2.5）岁，术后都留置镇痛泵。随机分成两组, 实验组41例，平均手术时间（1.5±0.4）小时, 分别于术后43h取镇痛泵和术后48h取导尿管。对照组41例，平均手术时间（1.6±0.2）小时，于术后48h同时取镇痛泵和导尿管。两组患者年龄、手术方式及手术时间比较，无统计学差异。